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AIDS and Behavior

, Volume 24, Issue 1, pp 151–164 | Cite as

The Relationship Between Discrimination and Missed HIV Care Appointments Among Women Living with HIV

  • Andrew E. Cressman
  • Chanelle J. HoweEmail author
  • Amy S. Nunn
  • Adaora A. Adimora
  • David R. Williams
  • Mirjam-Colette Kempf
  • Aruna Chandran
  • Eryka L. Wentz
  • Oni J. Blackstock
  • Seble G. Kassaye
  • Jennifer Cohen
  • Mardge H. Cohen
  • Gina M. Wingood
  • Lisa R. Metsch
  • Tracey E. Wilson
Original Paper

Abstract

Receiving regular HIV care is crucial for maintaining good health among persons with HIV. However, racial and gender disparities in HIV care receipt exist. Discrimination and its impact may vary by race/ethnicity and gender, contributing to disparities. Data from 1578 women in the Women’s Interagency HIV Study ascertained from 10/1/2012 to 9/30/2016 were used to: (1) estimate the relationship between discrimination and missing any scheduled HIV care appointments and (2) assess whether this relationship is effect measure modified by race/ethnicity. Self-reported measures captured discrimination and the primary outcome of missing any HIV care appointments in the last 6 months. Log-binomial models accounting for measured sources of confounding and selection bias were fit. For the primary outcome analyses, women experiencing discrimination typically had a higher prevalence of missing an HIV care appointment. Moreover, there was no statistically significant evidence for effect measure modification by race/ethnicity. Interventions to minimize discrimination or its impact may improve HIV care engagement among women.

Keywords

HIV Social discrimination Outpatient care Women Health status disparities 

Notes

Acknowledgements

Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): UAB-MS WIHS (Mirjam-Colette Kempf and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos and Anjali Sharma), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women’s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I—WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR000454 (Atlanta CTSA), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR).

Funding

This study was funded by the National Institutes of Health Grants U01-AI-103401, U01-AI-103408, U01-AI-035004, U01-AI-031834, U01-AI-034993, U01-AI-034994, U01-AI-103397, U01-AI-103390, U01-AI-034989, U01-AI-042590, U01-HD-032632, UL1-TR000004, UL1-TR000454, P30-AI-050410, and P30-AI-027767.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2019_2522_MOESM1_ESM.docx (119 kb)
Supplementary material 1 (DOCX 118 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Andrew E. Cressman
    • 1
  • Chanelle J. Howe
    • 1
    Email author
  • Amy S. Nunn
    • 2
  • Adaora A. Adimora
    • 3
  • David R. Williams
    • 4
    • 5
  • Mirjam-Colette Kempf
    • 6
  • Aruna Chandran
    • 7
  • Eryka L. Wentz
    • 7
  • Oni J. Blackstock
    • 8
  • Seble G. Kassaye
    • 9
  • Jennifer Cohen
    • 10
  • Mardge H. Cohen
    • 11
  • Gina M. Wingood
    • 12
    • 13
  • Lisa R. Metsch
    • 12
  • Tracey E. Wilson
    • 14
  1. 1.Department of Epidemiology, Centers for Epidemiology and Environmental HealthBrown University School of Public HealthProvidenceUSA
  2. 2.Department of Behavioral and Social Sciences, Center for Health Equity ResearchBrown University School of Public HealthProvidenceUSA
  3. 3.School of Medicine and UNC Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapelhillUSA
  4. 4.Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonUSA
  5. 5.Department of African and African American StudiesHarvard UniversityCambridgeUSA
  6. 6.Schools of Nursing, Public Health, MedicineUniversity of Alabama at BirminghamBirminghamUSA
  7. 7.Department of Epidemiology, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  8. 8.Montefiore and Albert Einstein College of MedicineBronxUSA
  9. 9.Department of MedicineGeorgetown UniversityWashingtonUSA
  10. 10.Department of Clinical PharmacyUniversity of CaliforniaSan FranciscoUSA
  11. 11.Departments of MedicineStroger Hospital and Rush UniversityChicagoUSA
  12. 12.Department of Sociomedical Sciences, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  13. 13.Lerner Center for Public Health Promotion, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  14. 14.Department of Community Health Sciences, School of Public HealthState University of New York Downstate Medical CenterBrooklynUSA

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